The project team will adapt the AHRQ Comparative Effectiveness Research Summary Guide, "Comparative Effectiveness and Safety of Oral Diabetes Medications for Adults with Type 2 Diabetes" to be literacy level appropriate, concise, targeted, and actionable. For this project, concise is defined as quickly read and understood;targeted is defined as explicitly tied to relevant clinical cases;and actionable is defined as being linked to a series of concrete steps users can take to follow or reject the Summary Guide's contents. Adaptation will be achieved through systematic modification of the Summary Guide contents using (1) feedback from focus groups of patients, healthcare providers and experts, (2) application of literacy and suitability design methods, and (3) delivery through interfaces that support action based upon the evidence. The team will then evaluate the adaptation and the effects of disseminating it to patients and to healthcare providers using a patient portal and electronic health record system, measuring a diverse set of process-related, qualitative, and clinical outcomes. The project will enroll patients and healthcare providers and will use a mixed methods approach to evaluate the impact disseminating the adapted evidence has on clinical outcomes, process-related outcomes and subject perceptions of both clinical evidence and patient portal systems. The project offers several innovative contributions. First, it defines a generalizable process for adapting summary guides for use by patients and healthcare providers. Second, the project applies state of the art health information technology to disseminate adapted comparative effectiveness research and attempts to reach providers both directly and through patients. This work will expand on burgeoning research investigating whether providing scientific evidence directly to patients is more effective than delivering it to busy healthcare providers, and whether such knowledge when learned from patients is incorporated into general practice. Taken as a whole, the project will contribute a novel method and generalizable knowledge for adapting and disseminating research evidence to varied targeted audiences using patient-directed decision support. PUBLIC HEALTH RELEVANCE: AHRQ has published a Comparative Effectiveness Research Summary Guide to treat Type 2 Diabetes Mellitus with oral medications. This project will adapt this Summary Guide to be concise, targeted, and easily actionable, and it will disseminate it to patients and healthcare providers through a patient portal and electronic health record system, respectively. The investigators will use qualitative and quantitative methodologies to evaluate understanding and application of the adaptation.